Colorectal cancer has a high incidence of morbidity and mortality in the North American population. Elevated levels of plasmalogens have been reported in some neoplastic tissues including colon tumors, but the mechanism for this increase has not been defined. Since changes in plasmalogen level are usually associated with changes in the other phospholipid subclasses, a general increase in all phospholipid subclasses may also be found in colonic neoplasms. In this study, the levels of the major phospholipids, including their plasmalogen and diacylphospholipid subclasses, were found to be elevated in human malignant colonic tissues. Since phosphatidylcholine is the most prominent type of phospholipid found in both malignant and control tissues, the mechanism for its accumulation during malignancy was investigated. Decreases in phospholipase C and D activities were observed in tumor samples, but an enhancement of the CTP: phosphocholine cytidylyltransferase activity was also detected. Immunoblotting analysis revealed that the elevated cytidylyltransferase activity was caused by a three-fold increase in the level of enzyme protein during tumor development. Based on these enzyme studies, we conclude that the high level of phosphatidylcholine in colon tumors resulted from a decrease in its turnover and an increase in its expression.

We report two cases of an unusual type of subpubic cystic mass occurring in postmenopausal women. They are formed by fibrocartilaginous tissue with extensive cystic degenerative changes and appear to be related to and perhaps originating from the periarticular tissues of the symphysis pubis. We could not find any reference to this lesion either in the standard gynecology and pathology textbooks or in a search of the published literature.

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The gastrointestinal effects of iron overdose have been described in children. They may occur acutely, ranging in severity from mucosal injury to complete infarction, or several weeks later, as obstruction due to stricture formation. They typically occur in the stomach or proximal small bowel. We describe an adult example of both, each occurring in the distal portion of the small intestine. Both patients had ingested enteric-coated iron preparations and both experienced significant, protracted abdominal pain. Thus adults as well as children are at risk for severe gastrointestinal complications after iron overdose. Significant protracted abdominal pain should alert the clinician of its possibility. Damage to distal areas of the bowel can occur with complete sparing of proximal portions particularly if the iron is an enteric-coated preparation.

Malignant change in pleomorphic adenoma of the salivary gland is not common. Clear cell carcinoma is an extremely rare form of malignant salivary gland tumor. A case of clear cell carcinoma of the submandibular gland arising in pleomorphic adenoma is reported.